As COVID-19 has spread through Colorado’s communities, more people have faced questions about the kinds of care they and their loved ones should receive in the case of a medical emergency or accident.
These questions have often had to be addressed in difficult circumstances. Especially in the virus’s early days, the course of COVID-19 was often unpredictable – while some people never had symptoms, others experienced long-term health challenges or death – and clinicians and family members sometimes faced painful choices. At the same time, social distancing restrictions made it harder to have conversations about preferences for care in person, especially when the person needing care was being quarantined.
Advance care planning – the process of identifying values, goals, and preferences for future medical care – can help a person, their family, and their doctors and nurses understand what to do in the case of this sort of medical emergency.
But most Coloradans have not created a formal plan – and in 2019, a smaller percentage of Colorado adults had a plan than in 2017, according to the Colorado Health Access Survey (CHAS). The portion of adults in the state who had discussed their plans with a doctor also dropped.
The CHAS highlights disparities that could have consequences for those who get sick and for their loved ones. Women, people with higher incomes, and people with more education are all more likely to have an advance directive. And the biggest drop in advance care planning in 2019 was among Hispanic/Latinx Coloradans, who have also had higher rates of infection and death due to COVID-19.
Advance Care Planning By the Numbers
Advocates for advance care planning say the first and most important step is to have conversations with loved ones or medical providers. The second is to identify a medical power of attorney – someone who can have those conversations on your behalf if you are not able to.
The CHAS asks Coloradans ages 18 and over if they have completed an advance directive, living will, or medical durable power of attorney. These tools help clarify who will make decisions in the case of an incapacitating condition and specify a person’s preferences for care if they cannot communicate for themselves. The CHAS also asks whether respondents discussed that plan with a doctor or with family and friends. (See CHI’s report on advance care planning from 2017 for more detailed explanations of advance directives in Colorado.)